Summary: Although everyone gets sad from time to time, depression is a severe problem with moods so sad that the person has troubles functioning, and may have various physical symptoms such as problems with sleep, appetite, and energy.

What is Depression?

Everyone has times when they feel the ‘blues' or when they get sad from time to time. Depression on the other hand, is a sadness so severe that it can cause:

Difficulties functioning at home, work or school

Changes in sleep, energy, appetite and concentration,

Feelings such as sadness, anxiety, irritability or anger,

Low self-esteem or feelings of hopelessness. When extremely severe, people who are depressed may have thoughts of hurting themselves.

How Common is Depression?

Depression is a common condition that can affect anyone at any age. In any given year, it is estimated that it affects almost 1 in 10 adults each year, affecting more women than men. Although it can occur at any age, it usually starts in late teens to mid-20's.

Symptoms of Depression

Symptoms of depression include (but are not limited to) the following:

Sad, depressed (or irritable) mood most days

Loss of interest or enjoyment in activities

Problems with appetite

Problems with sleep

Problems with concentration

Feeling guilty, hopeless, or worthless

Thoughts that life isn't worth living (such as thoughts of suicide) or attempts at suicide

When the above symptoms are consistently present for more than 2-weeks, it may be depression.

What Causes Depression?

There is no single cause of depression, and every person's depression may result from a combination of different things. Many factors can contribute to depression:

Family history of depression: if other people in the family have had troubles with depression, then it may make someone at higher risk.

Stressful life situations or events, such as problems with relationships, or stresses at work, home or school. Particularly stressful situations may include childhood abuse or neglect; separation/divorce, or conflicts.

Imbalances in neurotransmitters, which can be triggered by lack of sunlight, or drug use, medications, or medical problems.

How is Depression Treated?

There are numerous effective treatments for depression, which are generally given by mental health professionals.

Commonly used therapies include:

Cognitive behaviour therapy (CBT): Helps individuals cope with depression by focusing on changing their thoughts and behaviours. In depression, individuals tend to have negative, depressive thoughts. In CBT, individuals learn to replace depressive thoughts with more positive, helpful thoughts.

Interpersonal psychotherapy (IPT): Helps with depression by focusing on improving relationships. Regardless of how the depression started, individuals with depression tend to have tension in their relationships from either 1) conflict or withdrawal, or 2) life transitions or changes. IPT helps improve these difficulties.

Solution-focused therapy: Helps by finding solutions. In depression, individuals tend to focus on life stresses and problems. In solution-focused therapy, individuals get support in finding solutions to these difficulties.

Medications: May be helpful in certain cases, and these may be prescribed by a family physician, paediatrician or psychiatrist. Medications are generally used only when other treatments have not been successful, or when the depression is so severe that other treatments are not possible.

Depending on the severity of the depression, more intensive support and services may be required, such as admission to a hospital.

Helping Someone Who is Depressed

If you know someone who is depressed, it affects you too. The first and most important thing you can do to help a friend or relative who has depression is to help him or her get an appropriate diagnosis and treatment. You may need to make an appointment on behalf of your friend or relative and go with him or her to see the doctor. Encourage him or her to stay in treatment, or to seek different treatment if no improvement occurs after six to eight weeks.

To help a friend or relative:

Offer emotional support, understanding, patience and encouragement.

Engage your friend or relative in conversation, and listen carefully.

Never disparage feelings your friend or relative expresses, but point out realities and offer hope.

Never ignore comments about suicide, and report them to your friend's or relative's therapist or doctor.

Invite your friend or relative out for walks, outings and other activities. Keep trying if he or she declines, but don't push him or her to take on too much too soon. Although diversions and company are needed, too many demands may increase feelings of failure.

Remind your friend or relative that with time and treatment, the depression will lift.

How Can I Help Myself If I Am Depressed?

If you have depression, you may feel exhausted, helpless and hopeless. It may be extremely difficult to take any action to help yourself. But it is important to realize that these feelings are part of the depression and do not accurately reflect actual circumstances. As you begin to recognize your depression and begin treatment, negative thinking will fade.

To help yourself:

Exercise or do activities. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social or other activities.

Set realistic goals for yourself. In other words, don't set goals for yourself that are too large. Make smaller ones.

Break up large tasks into small ones, set some priorities and do what you can as you can.

Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.

Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.

Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.

If you Suspect Depression

If you suspect that you may have depression:

See your doctor. Your doctor can make sure there aren't any medical problems (such as hormone imbalances) that might be causing or contributing to the depression. Your doctor can also help recommend where else to get help, such as seeing mental health professionals such as a psychologist, psychiatrist or social worker.

In a Crisis?

If you are thinking about harming yourself, or know someone who is, then get help immediately:

Call a family member, friend or co-worker.

Call 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.

Make sure that you don't leave the other person alone.

For More Information

About this Document

Written by the eMentalHealth Team and Partners.

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

Creative Commons License

You are free to copy and distribute this material in its entirety as long as 1) this material is not used in any way that suggests we endorse you or your use of the material, 2) this material is not used for commercial purposes (non-commercial), 3) this material is not altered in any way (no derivative works). View full license at http://creativecommons.org/licenses/by-nc-nd/2.5/ca/

Patient Handouts

Overview
Bupropion (Wellbutrin®) belongs to a group of medications called antidepressants. Bupropion can be used to treat several other conditions.
What is bupropion used for?
When the potential benefits (e.g., reducing your symptoms) of using bupropion outweigh the potential risks (e.g., the side effects), many doctors may prescribe it to treat:
Depression
Depression associated with bipolar disorder
Attention deficit/hyperactivity disorder
Cravings associated with quitting smoking (sometimes prescribed as ’Zyban®’)
Your doctor may be using this medication for another reason. If you ...

What is duloxetine used for?
Duloxetine is used as part of the treatment of:
Depression
Depression associated with body pain
Generalized anxiety disorder
Anxiety disorders such as panic disorder, separation anxiety disorder, obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD)
Your doctor may be using this medication for another reason. If you are unclear why this medication is being prescribed, please ask your doctor.
How does duloxetine work?
Duloxetine is a “Serotonin and Norepinephrine Reuptake Inhibitor” (SNRI). This means it increases the amount of certain ...

What is mirtazapine used for?
Mirtazapine is used in various different conditions including:
Depression
Depression associated with bipolar disorder
Anxiety disorders like post traumatic stress disorder and panic disorder
Sleep disorders (insomnia)
Your doctor may be using this medication for another reason. If you are unclear why this medication is being prescribed, please ask your doctor.
How does mirtazapine work?
Mirtazapine increases the activity of certain chemicals in the brain called norepinephrine and serotonin. It is believed that some brain chemicals, such as norepinephrine and serotonin, are ...

Overview
Selective Serotonin Reuptake Inhibitors (SSRIs) belong to a group of medications called antidepressants. There are six SSRIs available in Canada. These include:
Citalopram (Celexa®)
Escitalopram (Cipralex®)
Fluoxetine (Prozac®)
Fluvoxamine (Luvox®)
Paroxetine (Paxil®)
Sertraline (Zoloft®)
What are SSRIs used for?
Though these medications are called “antidepressants” they may be used for conditions other than depression. When the potential benefits (e.g., reducing your symptoms) of using an SSRI outweigh the potential risks (e.g., the side effects), many ...

Overview
There are many different classes of antidepressants available in Canada. Some classes have been available for over 30 years, while others are relatively new. Traditional antidepressants, also known as “tricyclic” antidepressants (TCAs), include:
Amitriptyline (Elavil®)
Clomipramine (Anafranil®)
Desipramine (Norpramin®)
Imipramine (Tofranil®)
Maprotiline (Ludiomil®)
Nortriptyline (Aventyl®)
What are traditional antidepressants used for?
Though these medications are called “antidepressants”, they may be used for several conditions other ...

What is venlafaxine used for?
Venlafaxine is used as part of the treatment of various conditions such as:
Depression
Depression associated with bipolar disorder
Generalized anxiety disorder
Attention deficit/hyperactivity disorder (AD/HD)
Other anxiety disorders like social phobia
Your doctor may be using this medication for another reason. If you are unclear why this medication is being prescribed, please ask your doctor.
How does venlafaxine work?
Venlafaxine is a “Serotonin and Norepinephrine Reuptake Inhibitor” (SNRI). This means it increases the amount of certain chemicals in the ...

Medication Information

Add to Care Plan

What medications are used to treat depression?
Depression is commonly treated with antidepressant medications. Antidepressants work to balance some of the natural chemicals in our brains. These chemicals are called neurotransmitters, and they affect our mood and emotional responses. Antidepressants work on neurotransmitters such as serotonin, norepinephrine, and dopamine.
&nb...

Depression is commonly treated with antidepressant medications. Antidepressants work to balance some of the natural chemicals in our brains. These chemicals are called neurotransmitters, and they affect our mood and emotional responses. Antidepressants work on neurotransmitters such as serotonin, norepinephrine, and dopamine.

The most popular types of antidepressants are called selective serotonin reuptake inhibitors (SSRIs). These include:

Fluoxetine (Prozac)

Citalopram (Celexa)

Sertraline (Zoloft)

Paroxetine (Paxil)

Escitalopram (Lexapro).

Other types of antidepressants are serotonin and norepinephrine reuptake inhibitors (SNRIs). SNRIs are similar to SSRIs and include venlafaxine (Effexor) and duloxetine (Cymbalta). Another antidepressant that is commonly used is bupropion (Wellbutrin). Bupropion, which works on the neurotransmitter dopamine, is unique in that it does not fit into any specific drug type.

SSRIs and SNRIs are popular because they do not cause as many side effects as older classes of antidepressants. Older antidepressant medications include tricyclics, tetracyclics, and monoamine oxidase inhibitors (MAOIs). For some people, tricyclics, tetracyclics, or MAOIs may be the best medications.

What are the side effects?

Antidepressants may cause mild side effects that usually do not last long. Any unusual reactions or side effects should be reported to a doctor immediately.

The most common side effects associated with SSRIs and SNRIs include:

Headache, which usually goes away within a few days.

Nausea (feeling sick to your stomach), which usually goes away within a few days.

Sleeplessness or drowsiness, which may happen during the first few weeks but then goes away. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects.

Agitation (feeling jittery).

Sexual problems, which can affect both men and women and may include reduced sex drive, and problems having and enjoying sex.

Tricyclic antidepressants can cause side effects, including:

Dry mouth.

Constipation.

Bladder problems. It may be hard to empty the bladder, or the urine stream may not be as strong as usual. Older men with enlarged prostate conditions may be more affected.

Sexual problems, which can affect both men and women and may include reduced sex drive, and problems having and enjoying sex.

Blurred vision, which usually goes away quickly.

Drowsiness. Usually, antidepressants that make you drowsy are taken at bedtime.

People taking MAOIs need to be careful about the foods they eat and the medicines they take. Foods and medicines that contain high levels of a chemical called tyramine are dangerous for people taking MAOIs. Tyramine is found in some cheeses, wines, and pickles. The chemical is also in some medications, including decongestants and over-the-counter cold medicine.

Mixing MAOIs and tyramine can cause a sharp increase in blood pressure, which can lead to stroke. People taking MAOIs should ask their doctors for a complete list of foods, medicines, and other substances to avoid. An MAOI skin patch has recently been developed and may help reduce some of these risks. A doctor can help a person figure out if a patch or a pill will work for him or her.

How should antidepressants be taken?

People taking antidepressants need to follow their doctors' directions. The medication should be taken in the right dose for the right amount of time. It can take three or four weeks until the medicine takes effect. Some people take the medications for a short time, and some people take them for much longer periods. People with long-term or severe depression may need to take medication for a long time.

Once a person is taking antidepressants, it is important not to stop taking them without the help of a doctor. Sometimes people taking antidepressants feel better and stop taking the medication too soon, and the depression may return. When it is time to stop the medication, the doctor will help the person slowly and safely decrease the dose. It's important to give the body time to adjust to the change. People don't get addicted, or "hooked," on the medications, but stopping them abruptly can cause withdrawal symptoms.

If a medication does not work, it is helpful to be open to trying another one. A study funded by NIMH found that if a person with difficult-to-treat depression did not get better with a first medication, chances of getting better increased when the person tried a new one or added a second medication to his or her treatment. The study was called STAR*D (Sequenced Treatment Alternatives to Relieve Depression).2,3

Are herbal medicines used to treat depression?

The herbal medicine St. John's wort has been used for centuries in many folk and herbal remedies. Today in Europe, it is used widely to treat mild-to-moderate depression. In the United States, it is one of the top-selling botanical products.

The National Institutes of Health conducted a clinical trial to determine the effectiveness of treating adults who have major depression with St. Johns wort. The study included 340 people diagnosed with major depression. One-third of the people took the herbal medicine, one-third took an SSRI, and one-third took a placebo, or "sugar pill." The people did not know what they were taking. The study found that St. John's wort was no more effective than the placebo in treating major depression.4 A study currently in progress is looking at the effectiveness of St. John's wort for treating mild or minor depression.

Other research has shown that St. John's wort can dangerously interact with other medications, including those used to control HIV. On February 10, 2000, the FDA issued a Public Health Advisory letter stating that the herb appears to interfere with certain medications used to treat heart disease, depression, seizures, certain cancers, and organ transplant rejection. Also, St. Johns wort may interfere with oral contraceptives.

Because St. John's wort may not mix well with other medications, people should always talk with their doctors before taking it or any herbal supplement.

FDA warning on antidepressants

Antidepressants are safe and popular, but some studies have suggested that they may have unintentional effects, especially in young people. In 2004, the FDA looked at published and unpublished data on trials of antidepressants that involved nearly 4,400 children and adolescents. They found that 4 percent of those taking antidepressants thought about or tried suicide (although no suicides occurred), compared to 2 percent of those receiving placebos (sugar pill).

In 2005, the FDA decided to adopt a "black box" warning label—the most serious type of warning—on all antidepressant medications. The warning says there is an increased risk of suicidal thinking or attempts in children and adolescents taking antidepressants. In 2007, the FDA proposed that makers of all antidepressant medications extend the warning to include young adults up through age 24.

The warning also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment. Possible side effects to look for are depression that gets worse, suicidal thinking or behavior, or any unusual changes in behavior such as trouble sleeping, agitation, or withdrawal from normal social situations. Families and caregivers should report any changes to the doctor. To find the latest information visit the FDA website.

Results of a comprehensive review of pediatric trials conducted between 1988 and 2006 suggested that the benefits of antidepressant medications likely outweigh their risks to children and adolescents with major depression and anxiety disorders.5 The study was funded in part by NIMH.

Finally, the FDA has warned that combining the newer SSRI or SNRI antidepressants with one of the commonly-used "triptan" medications used to treat migraine headaches could cause a life-threatening illness called "serotonin syndrome." A person with serotonin syndrome may be agitated, have hallucinations (see or hear things that are not real), have a high temperature, or have unusual blood pressure changes. Serotonin syndrome is usually associated with the older antidepressants called MAOIs, but it can happen with the newer antidepressants as well, if they are mixed with the wrong medications.

Reprints:

This publication is in the public domain and may be reproduced or copied without permission from NIMH. We encourage you to reproduce it and use it in your efforts to improve public health. Citation of the National Institute of Mental Health as a source is appreciated. However, using government materials inappropriately can raise legal or ethical concerns, so we ask you to use these guidelines:

NIMH does not endorse or recommend any commercial products, processes, or services, and our publications may not be used for advertising or endorsement purposes.

NIMH does not provide specific medical advice or treatment recommendations or referrals; our materials may not be used in a manner that has the appearance of providing such information.

NIMH requests that non-Federal organizations not alter our publications in ways that will jeopardize the integrity and "brand" when using the publication.

Addition of non-Federal Government logos and Web site links may not have the appearance of NIMH endorsement of any specific commercial products or services or medical treatments or services.

If you have questions regarding these guidelines and use of NIMH publications, please contact the NIMH Information Center at 1-866-615-6464 or e-mail at nimhinfo@nih.gov.

The photos in this publication are of models and are used for illustrative purposes only.

School Letter

Add to Care Plan

I am writing to give you an update regarding your student, who having Mood Problems, i.e. Depression.
Accommodations are essential for this student to function in the academic program. Feel free to adapt this list, however, here is a general list of suggested accommodations.
Instructional Strategies
Interpersonal interventions
Fe...

I am writing to give you an update regarding your student, who having Mood Problems, i.e. Depression.

Accommodations are essential for this student to function in the academic program. Feel free to adapt this list, however, here is a general list of suggested accommodations.

Instructional Strategies

Interpersonal interventions

Feeling connected to people is particularly important with mood problems, particularly because students with mood problems youth tend to withdraw from others. Help connect the student to supportive peers, and offer opportunities to participate in organized school activities such as clubs, sports.

Make a special contact with the student each day. Maybe a specific greeting at the door followed by a question about something that has been of interest to the student.

Build strength and resiliency by reinforcing successes and positives

What times has your student been successful at things in the past? What are your student’s strengths? Tell the student about any positives.

Being successful and accomplishing tasks increases self-esteem so find ways to ensure the student has chances to achieve, even at his/her lower energy level and reduced ability to concentrate.

Reduce workload

Mood problems such as depression may lower the student’s ability to work. Consider temporarily reducing the academic expectations and workload. Just like one might modify job tasks for a worker with back injury, it is important to modify tasks for a student with mood problems.

Give more time

Students with mood problems tend to have problems with attention and concentration. Give more time, break assignments into smaller pieces, offer extra help in setting up schedules or study habits, or pair the student with others who express an interest in helping.

Coping / Stress Breaks (aka ‘Chill Time’) (Try to avoid the term ‘Time Out’ because for some students this has a negative connotation…)

Expressing stress -- Come up with a system to help the student identify when s/he is getting overwhelmed, and be able to communicate that to the teachers.

For example, using a 5-point scale, where 1 is no problems, and 5 is being stressed and overwhelmed

Create a safe space

Designate a “chill out zone” / “safe place” where the student can go if s/he is feeling overwhelmed. By giving the student the ability to calm down at school, this will lessen the chances that the student will end up leaving the school.

Talk ahead of time privately with the student, and set up some signal or cue so that the student can leave the class if the student is getting overwhelmed.

Set clear expectations

Many students have anxiety because they are uncertain about their teacher’s expectations. To help with this, provide the student with explicit guidelines for assignments. In addition, explicit guidelines for assignments help mitigate the negative impact of anxiety and depression symptoms on executive functioning. (Executive skills help a student to regulate his or her behavior. Through the use of these skills a student can plan and organize activities, sustain attention, and persist to complete a task.)

Classroom Education / Anti-Stigma

Consider having a lesson about mood problems, in order for other students to know about anxiety so that they can understand what the student with mood problems is going through. Do not single out the student with mood problems, but make the lesson a about mood problems in general. For more information, the CMHA has an excellent curriculum here www.cmha.ca/highschoolcurriculum/

Provide copies of classroom notes to cover absences due to anxiety, as the student may be missing classes due to anxiety, or doctor’s appointments.

Coping Plan

Involve the student in coming up with a coping plan, whose elements might include:

Student’s strengths

Potential problems or issues

Strategies and solutions to try

Suicidal ideation and crises

Although depression does get better in the vast majority of situations, youth with mood problems may become overwhelmed to the point where they may feel passively suicidal (“Life isn’t worth living”), or actively suicidal (“Life isn’t worth living, and I’m going to do something to end my life.”)

Learn about local resources (i.e. where you might get professional help) in case there are concerns about suicidality. Most likely, your school board already has a policy and procedure in place for such urgent situations.

Workplace Accommodation

Add to Care Plan

Examples of Common Workplace Accommodations
Accommodations should be based on your needs and the employer’s resources. There is no standard list of reasonable accommodations, but here is a list of commonly provided workplace accommodations:
Job coach assistance in hiring and on the job mentoring as necessary. Job coach/mentor could be from an external agency or be f...

Accommodations should be based on your needs and the employer’s resources. There is no standard list of reasonable accommodations, but here is a list of commonly provided workplace accommodations:

Job coach assistance in hiring and on the job mentoring as necessary. Job coach/mentor could be from an external agency or be from within the organization.

Flexible scheduling to accommodate effects of medications, time for appointments, more frequent breaks, switch to temporary part-time hours without fear of losing job.

Changes in supervision, for example how feedback and instruction are given, or having weekly supervision appointments to check in and prevent problems before they can happen.

In training, allowing more time for tasks to be learned, or allowing for individualized, one-on-one training.

Appropriate technology like a tape recorder to tape instructions, head phones to block out loud noise, etc.

Modifying work space or changing location so it is quieter, fewer distractions; allowing an employee to work at home.

Allowing an employee to exchange minor job tasks with others.

Rights and Responsibilities of the Employer & Employee

The Employer Should:

Create and maintain an atmosphere where people feel comfortable asking for accommodation, including providing information about the organization’s policies and creating ways for requests to happen confidentially.

Assume that the employee’s request for accommodation is made in good faith.

In a timely manner, work with the employee (and a professional, if necessary), to explore all options for accommodation.

Maintain records of the request and steps taken to deal with the request.

Maintain and respect confidentiality issues.

Pay the cost of the accommodations, including fees for any medical certificates required.

Request only information that is directly related to developing an appropriate accommodation.

Ensure that managers and supervisory staff will not tolerate any discrimination or harassment as a result of an illness or an accommodation.

The Employee Should

Tell the employer you need an accommodation, due to a disability, and give them the information they need to understand what the limitations are and what accommodations would address them.

A self-care manual to help employees and businesses cope with depression and mood problems at work. People can use it to identify whether they are experiencing depression or depressed mood, and apply practical strategies to reduce effects on work satisfaction and performance.

Depression Quest is an interactive fiction game where you play as someone living with depression. You are given a series of everyday life events and have to attempt to manage your illness, relationships, job, and possible treatment. This game aims to show other sufferers of depression that they are not alone in their feelings, and to illustrate to people who may not understand the illness the depths of what it can do to people.

Attending college or university opens up an exciting world of possibilities. It can also be pretty challenging. But if you’re living with a mental illness, you’ve faced challenges before. This resource is designed to make your transition to college or university just a little bit easier. It takes you through all the steps of going to school, providing information and tips for anyone living with a mental illness.

OurHealthyMinds is about mental health. It celebrates the many ways we can be well, and honours the many ways we can experience mental illness - as an individual, a caregiver, a parent, a child or loved one.

Care Plan

Helping Someone Who is Depressed

If you know someone who is depressed, it affects you too. The first and most important thing you can do to help a friend or relative who has depression is to help him or her get an appropriate diagnosis and treatment. You may need to make an appointment on behalf of your friend or relative and go with him or her to see the doctor. Encourage him or her to stay in treatment, or to seek different treatment if no improvement occurs after six to eight weeks.

To help a friend or relative:

Offer emotional support, understanding, patience and encouragement.

Engage your friend or relative in conversation, and listen carefully.

Never disparage feelings your friend or relative expresses, but point out realities and offer hope.

Never ignore comments about suicide, and report them to your friend's or relative's therapist or doctor.

Invite your friend or relative out for walks, outings and other activities. Keep trying if he or she declines, but don't push him or her to take on too much too soon. Although diversions and company are needed, too many demands may increase feelings of failure.

Remind your friend or relative that with time and treatment, the depression will lift.

How Can I Help Myself If I Am Depressed?

If you have depression, you may feel exhausted, helpless and hopeless. It may be extremely difficult to take any action to help yourself. But it is important to realize that these feelings are part of the depression and do not accurately reflect actual circumstances. As you begin to recognize your depression and begin treatment, negative thinking will fade.

To help yourself:

Exercise or do activities. Go to a movie, a ballgame, or another event or activity that you once enjoyed. Participate in religious, social or other activities.

Set realistic goals for yourself. In other words, don't set goals for yourself that are too large. Make smaller ones.

Break up large tasks into small ones, set some priorities and do what you can as you can.

Try to spend time with other people and confide in a trusted friend or relative. Try not to isolate yourself, and let others help you.

Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often during treatment for depression, sleep and appetite will begin to improve before your depressed mood lifts.

Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.

If you Suspect Depression

If you suspect that you may have depression:

See your doctor. Your doctor can make sure there aren't any medical problems (such as hormone imbalances) that might be causing or contributing to the depression. Your doctor can also help recommend where else to get help, such as seeing mental health professionals such as a psychologist, psychiatrist or social worker.

In a Crisis?

If you are thinking about harming yourself, or know someone who is, then get help immediately:

Call a family member, friend or co-worker.

Call 911 or go to a hospital emergency room to get immediate help or ask a friend or family member to help you do these things.

Call a crisis line.

If you know someone else who is in an immediate crisis, then:

Help the other person get help

Make sure that you don't leave the other person alone.

Screening Tools on eMentalHealth.ca

is a persistent, severe sadness that usually also causes problems with sleep, concentration, energy and appetite. This survey is designed to provide a quick assessment of whether you might have signs and symptoms related to depression. However, no test is 100% accurate. No matter what your score is, you should seek help if you have any concerns about yourself or your loved ones. The Depression Screening Questionnaire used here is a two-question screening tool recommended by the U.S. Preventive Services Task Force (USPSTF).